"There's a big tag on my head":exploring barriers to treatment seeking with women who use methamphetamine in Sydney, Australia

Abstract

Background Australia has a high prevalence of regular use of methamphetamine (MA). While half of people who use MA regularly are women, they make up only one third of people seeking treatment for MA use disorder (MaUD). There is a lack of qualitative research into the facilitators and barriers to treatment for women who use MA regularly. The study seeks a better understanding of the experiences and treatment preferences of women who use MA, to inform person-centred changes in practice and policy that break down barriers to treatment. Methods We conducted semi-structured interviews with 11 women who frequently use MA (at least once a week), and who are not engaged in treatment. Women were recruited from health services surrounding a stimulant treatment centre at an inner-city hospital. Participants were asked about their MA use and health service needs and preferences. Thematic analysis was completed using Nvivo software. Results Three themes were developed from participants' responses around experiences of regular MA use and treatment needs: 1. Resistance of stigmatised identity including dependence; 2. Interpersonal violence; 3. Institutionalised stigma. Clear service delivery preferences were also elicited, including continuity of care, integrated health care, and provision of non-judgmental services. Conclusion Gender-inclusive health care services for people who use MA should actively work to address stigma, support a relational approach to assessment and treatment, and seek to provide structurally competent health care that is trauma and violence informed, and integrated with other services. Findings may also have application for substance use disorders other MA.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics approval was obtained from St Vincent's Hospital Sydney Human Research Ethics Committee (LNR/15/SVH/469).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

Ethics approval does not permit sharing of the data.

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